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Key Text Children Affected by HIV/AIDS: Rights and Responses in the Developing World

Author: C Grainger and D Webb
Date: 2001
Size: 128 pages (1.2 MB)

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Summary

What is the situation of children affected by HIV/AIDS who live in poor countries? This Save the Children UK working paper tackles this question, and analyses the responses of households, communities, programming organisations, governments and donors. The paper emphasises the importance of improved monitoring and evaluation, and dissemination of lessons learned. It also recommends that agencies adopt a rights-based approach that mobilises communities and provides economic support through micro-finance.

The impacts of HIV/AIDS on children can only be understood through an examination of the children’s situation, especially: Economic status; social and cultural context, attitudes to, and knowledge of, HIV/AIDS; access to basic services; and the legal and policy environment. There are a range of direct impacts of the pandemic on children such as higher morbidity and mortality rates, lower life expectancy and increased orphaning rates. The morbidity and mortality rates of adults can affect the child’s principal support units, and so impact its development and chances of survival. The effects of this have not been adequately researched, but evidence to date suggests that major problems are: Education, health, food security, social welfare, protection and emotional health.

The ‘relief approach’ has often targeted orphans, as they are among the most vulnerable in society. However, this can stigmatise them further and discriminates against other vulnerable children. Using a child rights framework involves taking a broader approach, which emphasises multisectoral working, advocacy, participation, non-discrimination and equity.

An approach is needed which is flexible enough to address different contexts. Supporting spontaneous community-based approaches can achieve this. These often support adults in affected communities, taking into account the complex relationship of children to adult care and their wider communities.
The ability of families to cope with HIV/AIDS is largely dependent on stabilising or increasing their incomes. This can be effectively supported through micro-finance, as a complement to the community-based approach.
Children’s and communities’ needs often span a range of sectors, and so the most appropriate response is a multisectoral one. This should include impact mitigation, HIV prevention, and support for people living with HIV/AIDS.
Governments can provide the strategy direction for responses, and have a legal mandate to protect the rights of children.
There have been few systematic evaluations of programmes to mitigate the impacts of HIV/AIDS on children to be able to compare different approaches. The impacts are themselves poorly understood, welfare status of children changes quickly and the community may not consider evaluation to be a priority.

Only in the past decade have communities begun to experience the long-term impacts of HIV/AIDS on children. Despite pockets of local knowledge, there is still a collective ignorance of impacts and appropriate responses. General principles should emerge over time, and as experience is accumulated it is vital that it is shared. The report makes a number of recommendations for non-governmental organisations (NGOs):

NGOs working to mitigate impacts of HIV/AIDS on children should unite to advocate for child-focused policy and strong government-backed campaigns.
Monitoring and evaluation must be participatory, and produce clear and simple results. Indicators must be disaggregated by gender and age, and must be flexible enough to take into account changes in circumstances of children.
Greater collaboration is needed between agencies working on HIV/AIDS, and there is a need for greater sharing of information. As many countries are decentralising, it is important to build good relationships with local government.
There must be operations research to test effectiveness of different approaches, and examples of innovative and pragmatic approaches should be quickly disseminated.

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Source: Grainger, C. et al., 2001, ‘Children Affected by HIV/AIDS: Rights and Responses in the Developing World’, Save the Children UK, London
Author: Save the Children, UK (SCUK), http://www.savethechildren.org.uk